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Inspection report

Date of Inspection: 5 November 2012
Date of Publication: 28 November 2012
Inspection Report published 28 November 2012 PDF | 84.24 KB

People should be given the medicines they need when they need them, and in a safe way (outcome 9)

Not met this standard

We checked that people who use this service

  • Will have their medicines at the times they need them, and in a safe way.
  • Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 5 November 2012, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

People were not fully protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Reasons for our judgement

We looked at the records used in the management of medicines. The medication was mainly dispensed from a monitored dosage system and staff used a medication administration record (MAR) to confirm they had given medication as prescribed.

We observed the nursing staff administering medication to people sitting in the lounges and dining areas. They took time to ensure the person understood the reasons for administering the medicines. An agency nurse asked staff to confirm the name of the person before administering their medication. We noted that morning medication was still being administered by the agency nurse at 12:30pm. She began administering lunchtime medication at 1:00pm. She told us that she was finishing her shift at 2.30pm. Therefore needed to ensure people had received their medication before concluding her shift.

We raised concerns with regard to people not receiving their medication at the required times. She told us that she had made a note of the time when people had been given their morning medication to ensure sufficient time had elapsed between doses.

We spoke to the nurse on duty who was employed by the home. The nurse told us that it was normal practice for there to be one nurse on duty in the afternoon. This sometimes presented problems when ensuring people received their medication at the prescribed times.

We found that controlled drugs were stored in cabinets that complied with the law and correct stock levels were found and were written correctly in the register. The medication fridge was locked and there were records of checks to ensure medication was stored at the correct temperature.

We looked at the returns book and found the last entry was 25 October 2102. There was no entry to confirm drugs for disposal after that date had been recorded. We saw there was a large container which had a substantial amount of medication for disposal. The nurse told us that they did not have sufficient time to record medication for disposal. He said the supplying chemist accepted the medication without it being individually recorded. This made auditing difficult as there was no accurate record of medication being disposed of.

We looked at the medication policy and found there was no procedure regarding the disposal of medicines. We discussed the issue with the deputy manager who contacted the supplying chemist. They said they were developing a system to ensure the recording and receipting of medicines disposed of by the home. They confirmed that they were licensed to dispose of both the residential and nursing medication at the home. The acting manager was not able to show us a copy of the agreement.

We also found the medication policy lacked details regarding the procedure to follow if people refused medication or if they required medication to be administered covertly. This meant the service did not consider mental capacity and best interest decisions in relation to medication administration. This could have an impact on people who used the service as they may not have their medication as prescribed.